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Assessment of Cross-Border Monkeypox Importation Risk: A Modeling Study - Worldwide, 2022-2025.

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A new tool quantifies monkeypox (mpox) importation risk by integrating epidemic data and travel volume. This early-warning system provides timely alerts, enabling targeted public health interventions for cross-border mpox transmission.

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Area of Science:

  • Epidemiology
  • Public Health
  • Mathematical Modeling

Background:

  • Monkeypox (mpox) poses a significant global health threat.
  • Effective early-warning systems are crucial for managing cross-border transmission.

Purpose of the Study:

  • To develop a practical, rapid early-warning tool for quantifying country-level mpox importation risk.
  • To identify potential sources of cross-border mpox transmission.

Main Methods:

  • Utilized weekly confirmed mpox case data and international passenger volume (January 2022-November 2025).
  • Developed an importation risk index (RI) incorporating epidemic intensity, passenger flows, and public health capacity.
  • Employed a simplified ordinary differential equation framework to estimate regional RI parameters.

Main Results:

  • The RI showed strong lagged correlations with subsequent reported mpox cases.
  • Real-time RI provided earlier alerts in 93.3% of countries, with a mean lead time of 4.23 weeks.
  • Identified varying dominant sources of importation risk, supporting tailored control strategies.

Conclusions:

  • The cross-border risk assessment model offers an actionable framework for early warning and source attribution.
  • Supports targeted surveillance and proactive allocation of public health resources.
  • Highlights the importance of global health collaboration and timely data sharing for mpox control.